A cluster of states in the Midwest are seeing more of their coronavirus tests coming back positive — potentially an early indicator of a growing outbreak, Axios' Andrew Witherspoon and I report.

Between the lines: A high positive rate means that a higher share of those getting tested are sick. That could be because there are more sick people, or because a state isn't doing enough testing.

The big picture: Even though positivity rates are holding steady in some hotspots, that's not good news when they're plateauing at high levels.

• Florida, Nevada, Mississippi and Alabama are all still hovering near a 20% positivity rate, and the positivity rate is still rising in Texas.
• That means that those states have a high number of cases aren't doing enough testing or, most likely, some combination of the two.
• Arizona's rate is decreasing, although it's still around 15%.

Between the lines: Total U.S. testing this week decreased by nearly 13% compared to the week before, muddying the picture of what's going on in some states.

• Arkansas, for example, saw an increase in its positivity rate over the last two weeks, as its testing decreased by 34%.
• Nebraska, on the other hand, is also facing a growing positivity rate, but its testing increased by 9% — a bad combo.

The good news: New York has transformed itself from a national nightmare into a model for every other state, with a positivity rate of 1%. That suggests that it is testing more than enough people, and very few of them are sick.

President Trump signed an executive order Thursday that would require the federal government to buy "essential medicines" and certain medical supplies from American manufacturing plants, Axios' Bob Herman writes.

The big picture: Similar to Trump's recent executive orders that target drug prices, it's unclear how much this policy would change the drug and device supply chain, and there are several loopholes.

How it works: Under the executive order, which is fiercely opposed by the pharmaceutical and drug supply industries, the Food and Drug Administration has 30 days to make a list of medications, drug ingredients and medical devices that federal agencies would have to purchase from U.S. manufacturing facilities.

Yes, but: The executive order does not apply if the drugs and supplies are not already made in the U.S., or if the policy would "cause the cost of the procurement to increase by more than 25 percent."

Between the lines: The coronavirus outbreak raised concerns that the country is too reliant on foreign manufacturing, especially if things unexpectedly shut down and create shortages of lifesaving drugs and protective gear.

• But experts say drug manufacturers, wholesalers, pharmacies and others involved in making and dispensing drugs and supplies have strong financial incentives to produce and buy cheap — especially when it comes to generic drugs — and that usually means looking overseas.
• A vast majority of pharmaceutical ingredients, for example, are made in China and India. The executive order doesn't change the lower cost of labor or materials in those countries.

"It's not going to have a major impact," said Awi Federgruen, a supply chain professor at Columbia Business School. "You've got to create an incentive structure that will simply make it attractive for manufacturers to produce here rather than produce overseas."

Ohio Gov. Mike DeWine (R) tested negative for the coronavirus after initially testing positive earlier Thursday, his office announced.

More than 13% of health care workers in the greater New York City area tested positive for coronavirus antibodies, according to a newly published study.

About 69% of U.S. adults said they worry that states reopened too quickly as the country continues to confront the coronavirus pandemic, according to a national survey released Thursday by Pew Research Center.

The Bluetooth-based contact tracing system designed by Apple and Google is a current "gold standard" for prioritizing privacy when tracking the spread of the virus, Human Rights Watch executive director Kenneth Roth told Axios' Kim Hart at a virtual event Thursday.

An uptick in coronavirus cases in Europe is stoking fears that some countries, including France and Germany, could see a second wave, the New York Times reports.

• Both Germany and France have reported their highest number of new daily COVID-19 cases in months this past week. Some coronavirus mitigation efforts, like social distancing, aren't being enforced as strongly as they previously were.

Syria reported three health care workers in the al-Hol camp have contracted the coronavirus — making them the first known infections, Al Jazeera reports.

The coronavirus pandemic is accelerating the development of CRISPR-based tests for detecting disease — and highlighting how gene-editing tools might one day fight pandemics, one of its discoverers, Jennifer Doudna, tells Axios' Alison Snyder.

Why it matters: Testing shortages and backlogs underscore a need for improved mass testing for COVID-19.

• Diagnostic tests based on CRISPR — which Doudna and colleagues identified in 2012, ushering in the "CRISPR revolution" in genome editing — are being developed for dengue, Zika and other diseases, but a global pandemic is a proving ground for these tools that hold promise for speed and lower costs.

Driving the news: Last week, the NIH awarded $250 million for the development of COVID-19 diagnostic tests to a handful of companies, including Mammoth Biosciences, which is working on a CRISPR-based test that CEO Trevor Martin says will deliver 200 tests per hour per machine.

• Another CRISPR-based test, developed by Sherlock Biosciences and CRISPR pioneer Feng Zhang, received an emergency use authorization from the Food and Drug Administration in May — the agency's first for any CRISPR-based technology.
• "In a way, the timing of the pandemic coincided with this technology being ready to address this emerging need," says Doudna, a co-founder of Mammoth and a biochemist at UC Berkeley.

The challenge now is "getting it into a format where it can be used easily either in a laboratory or at the point-of-care," like the doctor's office or home, she says.

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